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APPLICATIO�FOR CONSTRUCTI� PERMIT <br /> CITY OF EVERETf•BUILDING DIVIS�ON �(((,,,��� <br /> 3200 CEDAR STREEi•EVERETT,WA 98201 •(G25)257-8810 <br /> ❑ DEMOLITION ❑ COMBINATION O BUILDING ❑ MECHANICAL ❑ PLUMBIN6 �16N <br /> PROJECT ADDRESS: 3 Y 2 S 13 vbas�W4� Qu-C_ <br /> 2r�, ��h iriYl.0 :Yz� P�wa1l..�w� [ws_ Gu��� w� �Xlo% 4ZS-�58-�3�0 <br /> w+wn wu�wonEss an r��� vr�pHc <br /> N� Flunlnsurn�ce �' �i 1�15-ssi - aBY� <br /> irw.ri uui�mrtss urr rro e�qr�f <br /> Qu_1Nt��s UlSuu.l. 5�.3{Gris' g��f (�IG. AN'LS. Sea`�tt WN �j9/3k lrb� 292- Qlbs <br /> •nL�x�rctOnOELGr4n u�n�IXx�EE c�tt )m M1qNF <br /> GfHlllµCOHT�[iQl Y111�C��[55 CI�Y Irt' AMY�f [���L IICtMSF• <br /> MiCv�NiC4Cp11PIC(IX1 MUI�COH55 CIM1 )�P Rq4f [1EffU[CNi[• <br /> PIIIYpMGCON1RIf,1pR 4�I1R1011E5S Cltt jN 1'IIpR $��tf110EN5f• <br /> Cp��MC �Mc[IX MOnR <br /> � 3 0 O. O o HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> ursrn�ecx»�x�wosou��rtroiwtnvavco . corrt•cinnson�ra Mo <br /> � cr � (il inrecn.+�� i«�,,...�wd-.� sl� �� ;2v�- . �_`-i� �9S'�,� <br /> e� cnh;rw � Wn-�l Si . s <br /> I NEREBY CERTIFV TN�T 1 II�VE HERD AND E%�MINEO THIS <br /> �irorosr0u5E a eund�n �PP���aTiON M10 KNOW THE SAME TO UE TRUE AN�CORRECT �LL <br /> PROVISIONS OF LAWS AND OAOINANGES GOVEFNING THIS tYPE Of <br /> WORK WILL BE COMPUED WITH WHEiHER SPECIFlED HERE�N OR <br /> tcceiocunmrronacmp�[nrv�v�o+weaaww�n¢Htw�mn[si NOT. TNE GP�NTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ior �� B�och s� M �.�V r� qUTKORIT° TO VIOUtE OR CANCEL TNE PROVISION OF ANY <br /> p L C O1NER STA1F,OR IOCAL L�W REOVLATINQ CONSTRUCiiON OR TNE <br /> 1 v{ LV-F-'CfQ`" �•J� [� al� L PERFORMAYCE OF CONSTRUCTION.TII�T I AM�UTNOFIZED BY THE <br /> -� OWNER OF Ti15 PROPER7Y TO PERFORM TNE WONK fOR WHICM <br /> (/�Nc�{- $�7 �'(" /y �S �(e nrrucnnor+ IS MADE AND 1 COMPLV WITN TNE Sil1TE <br /> r�n-rt un o Mwnrn CONTRACTO��S UW 1B 27 RCW AND P96100 WAC. <br /> GOviT�1L�,3731f R/Mqn[5�[IFI��Rrt1�MPO�� � F� � Q <br /> %_ l�`� Y "1�I,-1 -� C� Y `I9 <br /> -{7- sicq�tun 1 ou� <br /> r S�i C..� 1-1���^:s: ��l a�/ ' <br /> G'!&ILHC551'�INSCNO � <br /> PLUMBING GECNIINIGIL <br /> NO. TYPE OF FlKTURE 0111TEM FEE NO. iYPE OF EOUIPMENT FEE <br /> W�iER CLOSEi(TORET) A�C—MINDLG UNITS <br /> BATNTUB FORCED AIR SYSiEMS <br /> LAVATORY(WASH B�51Y� HERT PUMP <br /> SNO W ER UNIT H@ATERS <br /> ICIiCNEN SINK 8�ISP CLOTNES ORVERS <br /> DISNWqSNER RANGE HOOD <br /> L�VN�RY TRAV WATER NEATGF <br /> GLOTHES W�SNEH WOODSTOVE <br /> URIN4L MCTAL FI9EPLACE(WOOD BURNING� <br /> DRINNING FOUNTAM FIREPLAGE MSEPT(W00�BUPNINv) <br /> FLOOR DRAIN GA$fIREPLACE <br /> OACNFLOW PREVENTERS GASRANGE <br /> SR�R(SERVICL—BAA.ETC.) GAS PIPING <br /> E%NAUSTFAN <br /> SUBTOTAL f SUBTOTAL S <br /> PERMIt ! PEAMIT 5 --� <br /> TOTAL FCE f TOT/a,FEE f <br /> POR OFFICE USE ONLY: <br /> If1(1N�VTp�CM 11fAPSF1MCk SICEYIBI(Y, hWCll[CRNUYPfP ![F IUf.tll'fMp <br /> � �� - s� a -do� <br /> uselrnr (� im��[• /� u�c�rivrt FEES V�LU�TION FEE <br /> - �l. S�J/1'� OVES ❑No �_ <br /> eU1bM: <br /> H[rGu1VMRpqY� Nf(iOW[:Uw !IlhpllIX]41 � <br /> 3� ���,�� , %�,,.»,o � <br /> - — ----�— <br /> CC'�T�14fY 11l(�[IMIi15 OfCIR'�Nll �D 4�$(4[NI V(f,Nl�Nll:�l <br /> �O�ES p MO - -- <br /> ���[iA1�NxllflPEOD �i�iON �Od�H1M�l.i'I�NC�KC�t <br /> OINEP <br /> RRC AUPM PFOD M�cpV/ <br /> suir emiomn vmn.+n�.� <br /> nrtMcovci r�nns vtner CRYUFEVEHETT rnniMwcr�r< "'-' "' -- <br /> LOCALSALES -- — --� -- -' <br /> p.q�� �. �y,S 1 TA%CODE IS 0105 To7�L <br />